Anxiety Disorders Flashcards
What does the term neurosis mean?
A functional disorder whereby patients are distressed but do not have hallucinations or delusions. Synonymous with anxiety disorders.
In anxiety disorders what does fear lead to?
Arousal and avoidance
What is Lang’s three system model?
-> thoughts -> feelings -> behaviour ->
When danger is perceived or anticipated the brain activates what?
The autonomic nervous system- sympathetic part (release of adrenaline and noradrenaline) fight, flight or freeze
What is the primary (evolutionary) function of anxiety?
To protect - it is a response to danger or threat
When does the primary (evolutionary) function of anxiety become a problem?
When the perceived danger does not exist ie responding to an imagined psychological threat.
The brain is unable to distinguish between physical and psychological threat.
What effects does anxiety have?
Physiological arousal
Racing thoughts
Inability to concentrate
Cognitive bias - Attentin last focus
What is Padesky’s anxiety equation?
Anxiety = estimate of danger/ estimate of coping
What are the anxiety disorders?
Panic disorder (with or without agoraphobia) Social anxiety disorder Specific phobias Health anxiety OCD Body dysmorphia PTSD Generalised anxiety disorder
What is GAD?
Essentially a worry problem.
Specific content of worries changes/ varies
Includes worries about worries (type 2 worries)
What low level physical symptoms usually accompany GAD?
Insomnia
Muscle tension
GI problems
Headaches
In GAD the belief that worrying is useful is often maintained. True or false?
True e.g it motivates, shows responsibility, prepares for problems
What is social anxiety disorder?
The fear of a negative evaluation by others.
Can lead to avoidance of feared situations, use of safety behaviours, anticipatory anxiety, unhelpful post mortems following social encounters
What are the obsessions experienced in OCD?
Unwanted recurring distressing intrusive thoughts or images.
What are some examples of obsessions seen in OCD?
Being contaminated
Sexual imagery
Doubting
Aggression or horrific impulses
Are the intrusive thoughts in OCD ego dystonic or systonic?
Ego dystonic
E.g the thoughts are not pleasant and do not fit in with the person’s moral system or values
In OCD, to neutralise the distress caused by intrusions, the patient conducts what..?
Neutralising behaviours (compulsions)
Describe specific phobias
A marked fear of specific object or situation e.g dogs, balloons, flying, blood
Marked avoidance of such object or situations
Describe panic disorder
A fear of your own physiological and psychological reactions
Bodily changes viewed as signs of impending collapse, insanity or death
Accompanying avoidance of situations that may trigger these reactions is known as agoraphobia
What is agoraphobia?
A fear of being in situations where escape might be difficult or that help wouldn’t be available if things go wrong.
May be a fear of open spaces, travelling on public transport, visiting a shopping centre, leaving home
If find themselves in a stressful situation, usually experience symptoms of a panic attack
What are the symptoms of a panic attack?
Racing heartbeat Sweating Nausea Feeling faint SOB Chest pain Choking sensation Shaky limbs Numbness or pins and needles Dry mouth Ringing in ears GI disturbance Feeling or dread or fear of dying Feeling like you are not connected to your body
How long do most panic attacks last?
5 to 20 minutes
What are the main treatments for panic disorder?
CBT and medication - SSRI usually or TCA or pregabalin
Support groups
What are the general principles when treating animists with medication?
First line = SSRI
Consider SNRI or TCA
Benzodiazepines used for acute distress, not long term management due to tolerance and dependence
Pregabalin can be used as mono therapy or conjunction to antidepressant
Antipsychotics reserved for acute distress or sometimes to augment antidepressant therapy e.g in OCD
Beta blockers can improve somatic symptoms such as tremor and sweating, but do not impact cognitive anxiety
